Clinical Case Study: Abdominal Pain Evaluation

Which of the following conditions is most likely to be associated with unintentional weight loss due to malignancy?

What psychiatric condition listed is commonly linked to unintentional weight loss?

Which endocrine abnormality is associated with weight loss according to the content?

Which infectious disease is specifically mentioned as a cause of unintentional weight loss?

Which lifestyle factor is implicated in causing unintentional weight loss?

What is a common endocrine cause of unintentional weight loss?

Which hormone is primarily synthesized by the pituitary gland?

When examining a patient with abdominal pain and weight loss, which symptom might indicate an endocrine disorder?

Which symptom is NOT typical in cases of unintentional weight gain due to endocrine causes?

What aspect of obesity does pharmacotherapy primarily address?

In the context of endocrine disorders, what does a palpable liver indicate?

Which of the following is a characteristic finding in a patient with hyperthyroidism?

What is the primary focus in managing unintentional weight loss caused by endocrine disorders?

Patient History

Female, 62 years old.
Presented to the emergency department with severe abdominal pain and unintentional weight loss of 9kg in 3 months.
Reports experiencing anxiety, frequent palpitations, difficulty concentrating, dyspnoea and diarrhoea.
Prior abdominal CT scan, performed several weeks ago, displayed no abnormalities.

Patient Examination

Anxious and agitated
Vitals:
- Temperature 36.9 °C
- Blood pressure 160/90 mm Hg
- Pulse rate 130/min and regular
- Respiratory rate 22/min
Skin warm and moist.
Cardiac examination:
- Grade 2/6 systolic murmur.
Lung examination:
- Crackles heard.
Abdominal examination:
- Palpable liver 2 cm below the right costal margin.

Differential Diagnosis

Malignancy
Gastrointestinal disorders
Psychiatric conditions
Endocrine diseases
Infectious diseases
Neurological diseases
Advanced chronic disease
Chronic vigorous exercise
Medications/substances

Causes of Unintentional Weight Loss

Gastrointestinal disorders:
- Peptic ulcer disease
- Celiac disease
- Inflammatory bowel disease (IBD)
Psychiatric conditions:
- Depression
- Eating disorders
Endocrine diseases:
- Hyperthyroidism
- Adrenal insufficiency
- Diabetes (uncontrolled)
Infectious diseases:
- HIV
- Tuberculosis (TB)
- Chronic helminthic infections
Neurological diseases:
- Stroke
- Parkinson’s disease
Advanced chronic disease:
- End-stage heart failure
- Renal failure
Chronic vigorous exercise:
- Distance running
- Ballet dancing
- Gymnastics
Medications/substances:
- Alcohol
- Cocaine
- Amphetamines
- Prescribed drugs for diabetes, hypothyroidism.

Investigations

Bedside:
- Electrocardiogram (ECG) shows sinus rhythm at 144 beats per minute (bpm).
- Blood sugar (BM) 5.9.
Blood tests:
- Thyroid-stimulating hormone (TSH)
- (Normal Range)

This quiz focuses on a clinical case involving a 62-year-old female presenting with severe abdominal pain and associated symptoms. Participants will analyze differential diagnoses, consider examination findings, and understand potential underlying conditions. Increase your clinical reasoning skills with this engaging case study.